Die Lungenarterienembolie bei onkologischen Erkrankungen: Häufigkeit, Ursachen und Wahrnehmung

Zusammenfassung

Je nachdem, ob nur symptomatische Lungenarterienembolien (LAE) gewertet werden oder auch inzidentelle und initial übersehene Ereignisse, beträgt die LAE-Häufikgeit bei onkologischen Patienten 1,1 %–7,3 %. Die LAE-Häufigkeit ist sehr tumorspezifisch. Besonders häufig sind LAE bei Tumoren des Ovars (bis zu 25 %), des Pankreas, des Gehirns, des Uterus, sowie beim Multiplen Myelom zu finden. Besonders selten treten LAE bei Hodentumoren auf (< 1 %).

Die deutlich unterschiedliche Häufigkeit von LAE bei verschiedenen onkologischen Erkrankungen zeigt, dass die Assoziation von Malignomerkrankung und Tumor nicht für alle Malignome gültig ist. Eine Reihe von Argumenten, welche für diese Assoziation angeführt werden, sind auch für nicht-onkologische Patienten gültig.

Die Aufmerksamkeit des befundenden Radiologen und die Thrombusgröße bestimmen, ob eine unerwartete LAE beschrieben wird oder nicht. Insbesondere bei Malignomerkrankungen mit hoher LAE-Assoziation und bei metastasierten Tumorstadien ist eine erhöhte Aufmerksamkeit geboten.

Abstract

The frequency of pulmonary embolism (PE) in oncologic patients ranges from 1.1 % to 7.3 % depending on whether not only symptomatic findings but also incidental and initially overseen events are considered. The frequency of PE is tumor-specific. Most frequently PE occurs in patients with malignancy of the ovary (25 %), pancreas, brain, uterus, and multiple myeloma. Most rarely is PE found in patients with malignancy of the testis.

The tumor-specific frequency shows that the association of malignancy and PE is not equally true for alle malignancies. A number of arguments that support the above association are also valid in non-oncologic patients.

The awareness of the diagnosing radiologist and the thrombus mass decide whether or not an unexpected PE is detected. An increased awareness is suggested in patients with malignancies with high PE frequency and in patients with advanced oncologic disease.

Schlüsselwörter

Lungenarterienembolie - Tumor - Häufigkeit - inzidentell - Staging

Keywords

pulmonary embolism - malignancy - frequency - incidental finding - staging

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